ST GEORGE KIDS DENTAL, PLLC
NPI: 1275958191
· ST GEORGE, UT 84790
· Pediatric Dentist
· NPI assigned 03/01/2014
$471K
Total Medicaid Paid
Provider Details
| Authorized Official | PRYOR, TRENT (MEMBER) |
| NPI Enumeration Date | 03/01/2014 |
Related Entities
Other providers sharing the same authorized official: PRYOR, TRENT
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
2,297 |
$61K |
| 2020 |
2,732 |
$78K |
| 2021 |
4,648 |
$142K |
| 2022 |
5,205 |
$130K |
| 2023 |
1,302 |
$32K |
| 2024 |
1,129 |
$28K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
|
2,591 |
2,582 |
$294K |
| D0272 |
|
2,016 |
2,011 |
$45K |
| D0150 |
|
248 |
248 |
$37K |
| D1120 |
|
2,784 |
2,777 |
$24K |
| D2150 |
|
509 |
294 |
$17K |
| D1351 |
|
315 |
50 |
$11K |
| D0230 |
|
2,911 |
2,614 |
$9K |
| D1206 |
|
2,714 |
2,710 |
$9K |
| D2930 |
|
124 |
37 |
$9K |
| D0220 |
|
2,814 |
2,781 |
$7K |
| D2392 |
|
70 |
38 |
$4K |
| D0274 |
|
172 |
172 |
$2K |
| D0330 |
|
29 |
29 |
$2K |
| D2140 |
|
16 |
12 |
$575.07 |